Speaker 1: Scott's loan return. You're seven hundred WL. Here we go
Speaker 1: back half the week. We are good, sew. Here's what
Speaker 1: you need to know. Pharmaceuticals very expensive, especially insulin. If
Speaker 1: you are on insulin, you know how expensive that is.
Speaker 1: And the Federal Trade Commission a number of states and cities,
Speaker 1: and now Hamilton County, Ohio suing three pharmacy benefit managers
Speaker 1: at ECBs, care Mark, Express Scripts and optim Rx, as
Speaker 1: well as Eli, Lilly, Novo, Nordisk, and another manufacture, and
Speaker 1: those comprise about ninety six ninety seven percent of the
Speaker 1: insulin market. And the reason they're suing them is for
Speaker 1: allegedly fixing insulin and diabetes drug prices. So right now,
Speaker 1: if you look at the cost it what have cost them?
Speaker 1: Because about now less than are around two dollars a
Speaker 1: vile to make that sells for literally hundreds of times
Speaker 1: that we're talking one to three hundred times what the
Speaker 1: cost is. And the suit alleges illegal price manipulation on
Speaker 1: this is County Commissioner Denise Treehouse. Welcome back to the show, Denise.
Speaker 1: How are you.
Speaker 2: I'm good, good morning, Scott.
Speaker 1: Good Mark. You seem healthy. I'm healthy in this regard.
Speaker 1: I am not on insulin, and I also don't think
Speaker 1: I have anyone of my immediate family on insulin. But
Speaker 1: I hear the horror stories.
Speaker 2: Oh, there are many, many people that use insulin. It's
Speaker 2: a life saving drugs. And in Hamilton County we've got
Speaker 2: about eighty eight hundred county employees and family members that
Speaker 2: use insulin, and that.
Speaker 1: I believe is the highest drug category for coverage, right, yeah, yeah.
Speaker 2: Fromenty twenty three to twenty twenty five, this diabetes medication
Speaker 2: was the single highest cost prescription drug category for the county.
Speaker 1: Okay, So what triggered the county to jump in this lawsuit?
Speaker 2: Now?
Speaker 1: Was there a particular spiking costs complaints from employees or
Speaker 1: was it because the FTC settled with Express Scripts and said, hey,
Speaker 1: there's an opportunity here to go after the other pharmacy
Speaker 1: benefit managers and certainly the drug manufacturers.
Speaker 2: Well, prosecutor pillage this to our attention, to be fair,
Speaker 2: I didn't. This wasn't my idea, although I love the
Speaker 2: idea because other communities, as you just said, were waging lawsuits.
Speaker 2: They're about five hundred and fifty other entities, whether they're
Speaker 2: state cities, health plans and so they are, you know,
Speaker 2: weighing in on this, and we didn't want to miss
Speaker 2: the boat. It kind of reminds me of the opioid
Speaker 2: settlements where we were chewing and then we joined others
Speaker 2: in that lawsuit to bring some resources down to Hamilton County.
Speaker 1: All right, No, that makes sense. I know that the
Speaker 1: defendants here in this is in case the companies point
Speaker 1: out that previous insulin pricing cases have been dropped or
Speaker 1: lost or settled for no money. What makes you think
Speaker 1: this time is the magic charm, the magic bullet in
Speaker 1: Hamlin County and the other areas of successful days.
Speaker 2: Well, first of all, we're not paying anything upfront to
Speaker 2: wage the lawsuit because we only pay if we win,
Speaker 2: and so much like the opioid settlement, right, so we're
Speaker 2: not no money lost to hear. But also what we
Speaker 2: know is that, as you said, the cost of insulin
Speaker 2: is skyrocketed, but the cost to produce insulin has gone down,
Speaker 2: and so we are waging that they are colluding. They
Speaker 2: are it's false price fixing, and so that's what we're
Speaker 2: saying in the lawsuit. And I think we've got a
Speaker 2: really good case in winning, as do five hundred and
Speaker 2: forty nine other jurisdiction.
Speaker 1: Yeah, in the drug manufacturer as they say that the
Speaker 1: out of pocket costs are pretty low. Lily's been claiming listen,
Speaker 1: it's like less than fifteen bucks a month on average.
Speaker 1: So if the math mass there, if employees aren't paying
Speaker 1: hundreds of per mile out of pocket, who's actually bearing
Speaker 1: the inflated costs? That's the big question is taxpayers to
Speaker 1: the county plan And that's why the county's evolved because
Speaker 1: this is taxpayer money.
Speaker 2: Well, we're paying thirteen million dollars for insulin coverage for
Speaker 2: the county. That's a lot of money. And if we
Speaker 2: can reduce that cost because we don't have these folks
Speaker 2: colluding about price fixing, then we reduce the cost to
Speaker 2: the county, and that translates the cost savings for.
Speaker 1: The tax payers. The PBMs argue that they're actually the counterweight,
Speaker 1: that they balance pharmaceutical the pharmaceutical monopoly with this and
Speaker 1: that they can negotiate down prices. You how would you
Speaker 1: respond to that? Why they included in the suit?
Speaker 2: Then well, that's that's a question for the prosecutor. I mean,
Speaker 2: I'm not an attorney, and I don't pretend to be one,
Speaker 2: but the process.
Speaker 1: That's why I like you, Denise, That's why we like you.
Speaker 2: Yeah, I only say what I know. But Connie and
Speaker 2: her team have identified the as you say, the drug
Speaker 2: manufacturers and the benefit managers as part of this lawsuit.
Speaker 2: I trust that, and I'm more than happy to pile
Speaker 2: on and say, yes, this sounds like a good idea.
Speaker 2: We need to go after these guys and say the
Speaker 2: taxpayer some money.
Speaker 1: That's what I'm calling you. You were right in the
Speaker 1: coach of Cokannie's doing all the talk and you were
Speaker 1: standing in the background. I like that.
Speaker 2: I like that.
Speaker 1: You're going to a look crowdit for standing back there
Speaker 1: and ride the evape trail. She is Denniy's freehouse Hamlet
Speaker 1: County Commissioner. We're talking about the county now jumping on
Speaker 1: the lawsuit bandwag and no cost to the tax payers either,
Speaker 1: because there's a contingency basis. They went to the back
Speaker 1: of the proverbial phone book and found lawyers out to
Speaker 1: think out of phillyre somewhere and said, Okay, we're going
Speaker 1: to try this as a class and it's Philadelphia. It's also,
Speaker 1: as I mentioned, other states are getting involved with us
Speaker 1: as well. I think Hamilton in the first county to
Speaker 1: do this, and they're upset about obviously high insulin prices.
Speaker 1: You need that to live, and the costs of production
Speaker 1: are dwarfed by the cost it actually winds up paying
Speaker 1: by taxpayers and those people who need that medicine to live.
Speaker 1: We're talking one hundred two hundred, three hundred percent mark
Speaker 1: up on that, and that is the cause for the
Speaker 1: suit here too. But part of this is how much
Speaker 1: of this is should be at the federal government's feet though,
Speaker 1: you know, the opia you mentioned at the onset Denise
Speaker 1: about this kind of models the opiate lawsuit. But you know,
Speaker 1: as I recall with opiate, it's one of the big problems,
Speaker 1: was it no one ever addressed was well, you know,
Speaker 1: the FDA mandated, the government mandated that pain be treated
Speaker 1: as a fifth vital sign, and so that encouraged the
Speaker 1: over prescription of these things that later the government said,
Speaker 1: well they're bad for you. O. Well, you had a
Speaker 1: hand of that, you drove that. I think the same
Speaker 1: thing is here. You know, the one of the big
Speaker 1: problems is patent ever greening. I'm out of here familiar
Speaker 1: with that, but the original patents expired a decade ago,
Speaker 1: and what they do is they just slightly reformulated to
Speaker 1: keep the patent alive to make more money. Is that
Speaker 1: something you can be cleaned up by Congress?
Speaker 2: Well, I mean I think we should be tackling this
Speaker 2: at all levels, of course, but this one is you know,
Speaker 2: and by the way, we hope to be part of
Speaker 2: a multi jurisdictional litigation that's coming out of New Jersey.
Speaker 2: So that's what this is about. So we are filing
Speaker 2: it individually. And if we don't get to be part
Speaker 2: of the multi jurisdiction litification, that's fine, we'll pursue it
Speaker 2: on our own. But the idea here, it's much like
Speaker 2: the opioids, is to join together with others that are
Speaker 2: doing the same thing to bring down resources to our
Speaker 2: local community. If we don't file suit, we miss out.
Speaker 2: And why would we do that. I mean, you know
Speaker 2: so because so many others are in and yes, we
Speaker 2: should tackle this at all levels, but we don't want
Speaker 2: Hamilton County to be left out of you know, what's
Speaker 2: happened in many other states and jurisdictions.
Speaker 1: I always go on record, God, I always hate what
Speaker 1: politics is doing in this country right now, because it's
Speaker 1: so mindless in bottom feeding and my side v your side,
Speaker 1: And I'm not alleging you doing that, but I'd go
Speaker 1: back and go you know, this has been a problem
Speaker 1: for a long time. Why are we waiting until now
Speaker 1: to address it? Because this has been a problem under
Speaker 1: Republican administrations as well as Democrats. And the lawsuit targets
Speaker 1: PBS and manufactures. But like I said, you know, the
Speaker 1: rebate system we can get into that is the core problem.
Speaker 1: But like I said, you know, whether it's that or
Speaker 1: the patent issue, patent evergreening, or the PBM scheme that
Speaker 1: requires legislation to fix, not litigation, what's forcing Congress to
Speaker 1: actually do their job here other than going after the
Speaker 1: I guess the people are profiting it from which feels
Speaker 1: good and it's very, very populous, But again, it doesn't
Speaker 1: address the core issue, and that is government helped create
Speaker 1: this whole thing.
Speaker 2: Well, and I you know, I can't speak to why
Speaker 2: the government at the federal level is not acting on this.
Speaker 2: I mean I can't speak for them.
Speaker 1: No money is why they're not acting on it.
Speaker 2: Well, well, you know you have to ask them. And
Speaker 2: again I'm not going to speak for other people, but
Speaker 2: this litigation out of New Jersey is the prompt here.
Speaker 2: That is the reason for the action. Now there's something
Speaker 2: going on, it's got legs. We want to take advantage
Speaker 2: of that. We want to be part of it. And
Speaker 2: so that from my understanding, and again and prosecutor brought
Speaker 2: this to it, but that is a prompt on by
Speaker 2: way of timing, because there's something rolling down the tracks,
Speaker 2: and if we don't jump on and file suit, we
Speaker 2: miss and so we don't want to miss that. So
Speaker 2: the opportunity is now.
Speaker 1: Okay, if you win, though, get what you want in
Speaker 1: your fourth lower prices. What's going to prevent these companies
Speaker 1: from simply exiting the Ohio market.
Speaker 2: I don't know the answer to that.
Speaker 1: I mean, that's a third round. I don't know that
Speaker 1: they will, but that's a third round. Like, hey, if
Speaker 1: we can't make money off this, then we're out. We've
Speaker 1: seen that happen elsewhere and I don't know if that
Speaker 1: happened here or not, but that's that's pretty sobering. And
Speaker 1: then where you get your diabetes medication.
Speaker 2: Well, I'm not suggesting that these companies shouldn't make money.
Speaker 2: We're saying that they shouldn't be colluding with one another
Speaker 2: to jack up prices on taxpayers. That's what we're saying.
Speaker 2: I mean, I am not used to be a small
Speaker 2: business owner, as I've told you before. So you know,
Speaker 2: businesses make money. That's fine, they've got their nets, they're
Speaker 2: selling insulin, that's great. But to collude and falsely elevate
Speaker 2: prices is something entirely different. And so that's what we're saying.
Speaker 2: We're not saying they shouldn't make money, and they will
Speaker 2: make money, but they shouldn't make as much as they
Speaker 2: are by colluding with one another.
Speaker 1: Gotcha, did you guys have to make going into this
Speaker 1: to Connie share with you what the estimate of potential
Speaker 1: recovery is here? How much money?
Speaker 2: You know? I asked that question. So I just told
Speaker 2: you that we're spending about thirteen million for this cost
Speaker 2: of account. It's a lot of money, and so I mean,
Speaker 2: I don't know the answer to that, but if it's
Speaker 2: a few millions, that's really meaningful in a budget that's
Speaker 2: you know, strained and will be strained last year, it'll
Speaker 2: be strained next year. But any money that we can
Speaker 2: find to help with that is going to be to
Speaker 2: our benefits for sure?
Speaker 1: Who would get the money? Does go back in the
Speaker 1: general fund? Does it? Does it go directly towards prescription
Speaker 1: prices and offset with the county pays? Does it go
Speaker 1: to to the Bengals? Where's the money going? Somehow went there?
Speaker 1: I think Mike Brown gets a percentage. I don't know
Speaker 1: how this sits. Apparently in the master agreement is.
Speaker 2: Your preoccupation with the bankers? But no, no, it'll go
Speaker 2: into the general fund. And so then we have to
Speaker 2: make a decision commissioners. You know, the general fund pays
Speaker 2: for the deputies for for nine to one one call takers.
Speaker 2: Are all the things that we've always talked about? Or
Speaker 2: is it a benefit to those that are in the
Speaker 2: benefits system, the healthcare system of the county. And do
Speaker 2: we offer some relief somewhere else for our employees or
Speaker 2: do we put it more towards the general fund for
Speaker 2: more general purposes? And that's something we'll have to decide.
Speaker 1: Down the road. If this is successful, does that open
Speaker 1: the door for other suits for other things that might
Speaker 1: be expensive? I mean, do you just continue this path?
Speaker 1: I'm not saying it's a bad path, but what open mind. Hey,
Speaker 1: we got money, We're able to fix this. What's next.
Speaker 2: Well, I think we always should be open to an
Speaker 2: opportunity when there's a big suit going on in multi
Speaker 2: jurisdiction litigation, I think we should always be open to
Speaker 2: piling on it is worthy, right, if it's worthy of
Speaker 2: our attention. Again, we're not paying any money to do
Speaker 2: this right now, it's on a contingent basis, So that's
Speaker 2: the good news for the taxpayers. But yeah, I don't
Speaker 2: know why we wouldn't look for opportunities to write size
Speaker 2: things in Hamilton County. But again, you know, I'm not
Speaker 2: the prosecutor, and so the prosecutor's job literally is to
Speaker 2: file these actions with the support of the Commission, and
Speaker 2: so that's what we're doing here.
Speaker 1: Yeah, yeah, I mean this has been a let's face it,
Speaker 1: back to politics. This has been a talking point for
Speaker 1: Democrats for a long long time. I mean, it used
Speaker 1: to be the insulin cost two dollars to make. That's
Speaker 1: been thrown around for a long long time. And now
Speaker 1: we're there's action on this. And you know, obviously Democrats
Speaker 1: get hammered on cost of living issues, and now that's
Speaker 1: starting to turn the other way. But you know, I
Speaker 1: think this is maybe a populist idea here that has
Speaker 1: some legs, and find out exactly if you can get
Speaker 1: some money back from these companies. I just wonder, why
Speaker 1: don't we just address the route. As you said, that's
Speaker 1: outside of your scope as a commissioner. I appreciate and
Speaker 1: understand that. I think we're both frustrated with the system
Speaker 1: the way it is right now, especially with healthcare. I
Speaker 1: don't know if this fixes it, but it does cost
Speaker 1: some of that money back, because you know, if you
Speaker 1: need insulin to live and you can't afford it, that's
Speaker 1: a huge problem. And also that thirteen million dollars that
Speaker 1: the county pays, and these are for people who have
Speaker 1: coverage because they work for the county. There's so many
Speaker 1: people that don't. And that's a scary part well.
Speaker 2: And you know, we don't want these companies taking advantage of,
Speaker 2: you know, providing a drug that's life saving to people
Speaker 2: in our community. I mean, it's insulting, I think. And
Speaker 2: so when you particularly when you talk about insulin, because
Speaker 2: it's not like this is some drug that people may
Speaker 2: or may not want to use. This is life saving.
Speaker 2: People need the drug and to to collude over the
Speaker 2: prices of insulin, I think is an insult. I really do.
Speaker 2: And so we're holding the companies accountable. I think that's
Speaker 2: what we should do. I think that's what frankly, people
Speaker 2: expect of their elected officials. And so, you know what
Speaker 2: we're doing it the time is right. I can't really
Speaker 2: speak to the timing otherwise, but I know that the
Speaker 2: timing is right here to join this suit coming out
Speaker 2: of New Jersey, And so that's what we're doing.
Speaker 1: Do you believe there's a collusion going on or is
Speaker 1: that is that a fact?
Speaker 2: Has it been proven that that is what is being alleged.
Speaker 1: Yeah, that's a tough one to prove that they're all
Speaker 1: in on this together than saying, hey, it costs what
Speaker 1: a cost. And the way the system is set up
Speaker 1: that that those who regulate the system allowed this to occur.
Speaker 1: I think it'd be more of an indictment of the
Speaker 1: of the politic of those again above us in Washington
Speaker 1: versus the companies themselves. They've they've got to find a
Speaker 1: way to make money. And it's kind of like you know,
Speaker 1: the cries over you know, billionaires paying too few tax
Speaker 1: as well. Okay, then fix the system, close those loopholes
Speaker 1: that you allege are there. That's why are you beating
Speaker 1: down on the people who are smart enough to figure
Speaker 1: that out.
Speaker 2: I agree, But we just talked about the cost of
Speaker 2: producing insulin going down, and yet the cost of buying
Speaker 2: it is going up. So there's something going on here.
Speaker 2: I think that doesn't make sense, and so I agree
Speaker 2: with you that you know these are broader issues. We
Speaker 2: can do what we can do here in Hamilton County
Speaker 2: to protect the taxpayers here. That's my job and that's
Speaker 2: what we're trying to do. And you know, it's not
Speaker 2: as if others don't see what's happening. I mean, five
Speaker 2: hundred and fifty other jurisdictions of files too, So this
Speaker 2: is a big movement and certainly people are paying attention.
Speaker 1: Yeah, it's on the heels of tobacco. It's on the
Speaker 1: heels of the opiate issue as well, and this certainly
Speaker 1: fits into that categories. Like the next thing is affordable
Speaker 1: drugs insulin for crying outline. I mean, there's other drugs
Speaker 1: out there. I think, like you know, the EpiPen thing.
Speaker 1: Epinephrine is another in that effects far fewer people than
Speaker 1: than insulin, but I'd imagine if this is successful, that
Speaker 1: might be something that would be explored. It's a life
Speaker 1: saving medication that you need. And you know, we heard
Speaker 1: that for a long time. It's like, well they only
Speaker 1: last I forgot, what is ninety days or six months
Speaker 1: or something like that, and we've got to throw them
Speaker 1: out and get a new one. And it's just simply
Speaker 1: not affordable. We don't heard those crises as much anymore.
Speaker 1: There are some I think there were some regulation that's
Speaker 1: been done, but you know, there are plenty of drugs
Speaker 1: out there that you could wind up going after as
Speaker 1: a result of this.
Speaker 2: Well, that's right, and epiethin's are extremely expensive. So I've
Speaker 2: got some personal experience with one of my relatives, right,
Speaker 2: So yeah, I mean, I agree with you. And let's
Speaker 2: not forget though that the benefit and this is a
Speaker 2: little different from the opioid settlement money, but those dollars
Speaker 2: that we are investing now because we were successful and
Speaker 2: that lawsuit, are going directly into Hamilton County to save
Speaker 2: lives and get people into treatment. I mean so, and
Speaker 2: then it's coming through the foundation at the state level,
Speaker 2: but there are direct payments coming to Hamilton County and
Speaker 2: other jurisdictions in Hamilton County to the benefit of our constituents.
Speaker 2: So this is real. The benefits are real. This is
Speaker 2: a little different because it's going to the general fund,
Speaker 2: but those are taxpayer dollars and so you know, I
Speaker 2: just don't want to understate that there's a real benefit
Speaker 2: here if we win and there's no cast involved to
Speaker 2: do it, so you know, again, to me, it's just
Speaker 2: a win win situation. So yeah, but the benefits can
Speaker 2: be real and seen on the ground.
Speaker 1: Has this fir amount in New Jersey? Have the litigators
Speaker 1: giving you a timeline? No?
Speaker 2: I asked that question too, and you know how attorneys
Speaker 2: are They were, oh, yeah, not sure, you know we're
Speaker 2: doing like all right, all right, I get it. So yeah, no,
Speaker 2: I'm you know, I'm not an attorney, and I'm not
Speaker 2: I'm not disappointed by it.
Speaker 1: Yeah right, Well I'm sna. There's plenty attorneys out there,
Speaker 1: have some of our good friends of mine, and then
Speaker 1: there's people like yeah, yeah, yeah, I get it, get it. Hey, Denise,
Speaker 1: thanks for jumping on this morning. Answer the question certainly
Speaker 1: an interesting perspective. We're going to talk about this a
Speaker 1: little bit behind your back if you don't mind, we'll
Speaker 1: get some calls and from people affected by this and
Speaker 1: you have a wonderful day. Thanks again for jumping on.
Speaker 2: Hey can I ask you something?
Speaker 1: Yes, ma'am.
Speaker 2: Yes, So, I don't know how much time we have,
Speaker 2: but we did do a big dedication yesterday out at
Speaker 2: in Bonds Hill for the big building, the Mercy Building
Speaker 2: out there.
Speaker 1: Yes, right right right, yeah, yeah, please go ahead, yeah yeah.
Speaker 2: So two days we named the street going up to
Speaker 2: the building, Pat McCollum Way. This is a named after
Speaker 2: a woman that took in many, many kids in our
Speaker 2: community both foster care adoptive care, and was tragically killed
Speaker 2: not so long ago, and so we named the street
Speaker 2: after her because of the nexus with jobs and family services,
Speaker 2: so we wanted to honor her legacy through naming the street.
Speaker 2: But the building itself was owned by Mercy. We now
Speaker 2: have it. It's a consolidation of county services up in
Speaker 2: one site, so lots of efficiencies here for jff d D,
Speaker 2: public health, addiction response, environmental services, and veteran services are
Speaker 2: going to be up there. So it's centrally located in
Speaker 2: the county. And I just want to say there's free parking.
Speaker 2: There's free parking at this facility. There are a thousand
Speaker 2: spots out there, and so you don't I always hear
Speaker 2: about the cost of parking, how terrible it is to
Speaker 2: come downtown. That is no longer the case, and so
Speaker 2: we're very excited about this. It's accessible to people that
Speaker 2: need that kind of access, particularly veterans. So we're really
Speaker 2: excited about the opening of the building and we dedicated
Speaker 2: it yesterday.
Speaker 1: You know, we were texting back and forth. I completely
Speaker 1: forgot because I'm stupid to mention. I'm glad you brought
Speaker 1: that up because I wanted to definitely get a plug
Speaker 1: in for that six I think sixty million dollars was
Speaker 1: the cost. Now you also have This is the other
Speaker 1: hard part here is this huge levey on the ballot
Speaker 1: for children's services. But loves to revisit that maybe the
Speaker 1: later date, because those two things go together. You got
Speaker 1: the building, but now you got a fund.
Speaker 2: Well, the other thing is that we're getting out of
Speaker 2: a bunch of different buildings because of all those departments.
Speaker 2: We're in different buildings all over the city and so
Speaker 2: as we just like the alms and depky Downtown is
Speaker 2: a good example of it that is now going to
Speaker 2: be converted into housing, as will a property up in
Speaker 2: Walnut Hills. And so it's really great for the communities
Speaker 2: because we're and you see this all over the country,
Speaker 2: we're converting office space into residential and we need residential.
Speaker 2: So it's just really a great move for the county
Speaker 2: and it's going to save money.
Speaker 1: All right, I'm sure we'll talk about that a later
Speaker 1: date with the love come up and Denise sall the best.
Speaker 1: Thanks for jumping on. I appreciate you.
Speaker 2: Yeah, sure, thanks, all right, got.
Speaker 1: Well, let me get a news update in. I want
Speaker 1: to talk if you're on the insulin. I'm just curious
Speaker 1: because I don't have anyone in my family that is,
Speaker 1: and that's a blessing for sure, because I know how
Speaker 1: hard that is being diabetic, but the impact of that,
Speaker 1: I'm your wallet. And also, if you think this is
Speaker 1: a good idea ensuing the drug companies to get the
Speaker 1: price of insulin down, we'll talk about that, dex. I'll
Speaker 1: give you some reasons as to why you know this
Speaker 1: this whole scenario exists. I mentioned the government getting involved
Speaker 1: in regulation that can easily fix on me easily but
Speaker 1: fixed by Congress I want to touch on that in
Speaker 1: just minutes, and we'll get your phone calls in at
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